Practical manual of diseases of women and uterine therapeutics : for students and practitioners / by H. Macnaughton Jones.

  • Jones, H. Macnaughton (Henry Macnaughton), 1844-1918.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Practical manual of diseases of women and uterine therapeutics : for students and practitioners / by H. Macnaughton Jones. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    CHAPTER n. THE EXAMINATION OF A CASS. As in other organs, that physician is most likely to arrive at a sound basis for his treatment who makes his first examina- tion a systematic and careful one. Many an error in diagnosis might be saved if we adhered to this rule. One word of caution is necessary. While unnecessary examinations of the uterus are, above all things, to be deprecated, on the other hand, nothing can be more dangerous to a medical man's reputation than the neglect of making a careful vaginal examination, when he is in doubt as regards the nature of a difficult case, and one clearly pointing to some affection of the pelvic viscera. Want of caution in this respect has brought many a young medical man into disgrace. Take, for example, haemorrhage, the result of undetected uterine polypus,* or overlooked malignant disease of the uterus; a vaginal discharge attendant upon pelvic cellulitis; irrita- bility of the bladder, due to a flexion or version of the womb, or to a pelvic haematocele, or a uterine fibroid; some difficulty in defsecation, attendant on a tumour, pelvic cellu- litis, or uterine displacement; frequency in making water, due to undetected stone in the bladder • a prolonged back- pain, the result of retroversion of the uterus. These are just a few instances of the many cases in which the want of a careful vaginal examination, in the first instance, is certain to reflect discredit, through some undiscovered morbid or abnormal condition of bowel, uterus, or bladder. * See Chapter on Dysmenorrhea.